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DEATH
CERTIFICATE
JAKE BRADLEY
Date 04 October 1939
Cert: 24649
Place of Death: County: Floyd Co. City
or Town: Martin
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Floyd
City or Town: Martin, Ky. Street
No.: New Martin 41
Full Name: Jake BRADLEY
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Raney BRADLEY
Age of husband or wife if alive: (blank)
Birth date of deceased: 17 June 1882
Age: 57 years, 03 months, 17 days
Birthplace: Knott Co.
Occupation: Labor
Industry or business: (blank)
Father Name: Jake BRADLEY
Father Birthplace: Knott Co.
Mother Maiden Name: Barbra WATKINS
Mother Birthplace: Knott Co.
Informant: Raney BRADLEY, Martin
Burial Place: Martin
Date: 05 October 1939
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar: 15 October 1939
Registrar's Signature: Mrs. Ben Norris
Date of Death: 04 October 1939
I hereby certify that I attended deceased from 15 August 1939
to 01 October 1939, that I last saw him alive on 01 October
1939, and that death occurred on the date stated above at 2:35
a.m.
Immediate cause of death: Hypostatic pneumonia
Due to: Alcoholism
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: Dr. F. E. Burgess, Martin
Gen. Hosp., Martin, Ky.
Date signed: 19 October 1939
Transcribed by Debbie Tamborski, 01 May 2010 |
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